Value of monoenergetic dual-energy CT (DECT) for artefact reduction from metallic orthopedic implants in post-mortem studies

Filograna, Laura; Magarelli, Nicola; Leone, Alessandro; Guggenberger, Roman; Winklhofer, Sebastian; Thali, Michael J.; Bonomo, Lorenzo

doi:10.1007/s00256-015-2155-z

Cited by 40 publications

(25 citation statements)

References 36 publications

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“…We found that the overall image quality improved with reduced artifacts using iMAR or DECT which is in line with similar studies [5,12,22]. Also, the optimal keVs for monochromatic images found here are similar to those found by others [4,23].…”

Section: Discussionsupporting

confidence: 92%

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Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

2020

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Section: Discussionsupporting

confidence: 92%

“…It is well known that metal artifacts can also be reduced using virtual monochromatic images extracted from dual-energy CT (DECT) scans [4][5][6]. In DECT, two different energy spectra are used to acquire CT images [7].…”

Section: Introductionmentioning

confidence: 99%

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

2020

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“…Subsequent studies reported optimal monoenergetic levels ranging from 105 kV to 148 kV. [5][6][7][8] These studies varied in terms of the region imaged, material, and the geometry of the implants that may affect the optimal monoenergetic level.…”

Section: Discussionmentioning

confidence: 99%

Metal Artefact Reduction by Dual-energy Computed Tomography Using Monoenergetic Extrapolation: In-vitro Determination of Optimal Monoenergetic Level with Different Metallic Implants Using a Phantom Body

Chan¹,

Tsang²,

Wong³

et al. 2016

Hong Kong J Radiol

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Objective: To identify the optimal monoenergetic level, balancing metal artefacts, and the amount of noise present for imaging of metal implants using dual-energy computed tomography (CT) and focusing on the assessment of peri-prosthetic soft tissue. Methods: Four metallic implants commonly used in the hips were placed in a phantom body: unipolar hemiprosthesis, dynamic hip screw (DHS), intra-medullary (IM) nail, and titanium insert. The unipolar hemiprosthesis was imaged at two points: the head and stem. The head of the hemiprosthesis and DHS were imaged in two axes: one axial to and one resembling the angle at its expected position in the hip with respect to the scanner. The IM nail was assessed both at the level with and without a screw inserted. A region of interest to measure the noise level of the images was first performed with different monoenergetic levels (70-170 kV with increments of 10 kV). Four monoenergetic levels were then chosen (80, 90, 105, 120 kV) for each implant and were assessed and scored (presence of least to most artefacts: score 1-4) by nine radiologists who were blinded to the monoenergetic level. A total of eight sets of images were assessed. The scores for different monoenergetic levels were compared using analysis of variance. Results: In the first part of the experiment, the images with the least amount of noise were in the range of 85-95 kV, thus we included 90 kV among the images for subsequent scoring. The mean score for different monoenergetic levels for all implants was as follows: 3.94 for 80 kV, 2.68 for 90 kV, 1.50 for 105 kV, and 1.88 for 120 kV (p <0.001), with 105 kV having the least metal artefacts. For subgroup analysis of individual implants, 105 kV was found to produce the best quality images with a statistically significant better score for hip stem, DHS, and IM nail. 120 kV trended towards being the best monoenergetic level when imaging the hip head and the IM nail with screw where relatively more artefacts were present. 90 kV trended towards being the best monoenergetic level when imaging the titanium insert where artefacts were nearly absent. Conclusion: With regard to imaging the soft tissue around a metallic implant, the overall optimal monoenergetic level for reduction of metal artefacts using dual-energy CT is 105 kV. When more artefacts are inherently present, 120 kV trended towards being the best monoenergetic level. When artefacts are minimal, 90 kV trended towards being the optimal monoenergetic level with the least amount of noise present.

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“…Auch eine knöcherne Konsolidierung der Frakturen kann hiermit überprüft werden. Sollten umfangreiche Implantate einliegen, kann die Wahl einer Dual-Energy-Computertomografie sinnvoll sein [4]. Bei klinischem Verdacht auf eine Achs-oder Längenfehlstellung kann zusätzlich eine konventionelle Achsbeinstandaufnahme, bei Verdacht auf einen Rotationsfehler eine Rotationscomputertomografie indiziert sein.…”

Section: Analyse Der Fehlgeschlagenen Osteosyntheseunclassified

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen am Tibiaschaft und an der distalen Tibia

Riesenbeck¹,

Raschke²

2020

OP-JOURNAL

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Die Revisionsoperation stellt hohe Anforderungen an den Operateur. Er muss dem Patienten eine fehlgeschlagene Osteosynthese berichten, ohne ihn zu entmutigen. Gleichzeitig soll er die Zuversicht vermitteln, mit der Revision die Beschwerden zu lindern, ohne übertriebene Erwartungen zu wecken. Außerdem muss er die richtigen fachlichen Entscheidungen über Zeitpunkt und Art und Weise treffen und schlussendlich die Operation technisch einwandfrei unter den erschwerten Bedingungen eines Folgeeingriffs ausführen. Der nachfolgende Artikel versucht, einen systematischen Ansatz zur Planung von Revisionsoperationen an Tibiaschaft und distaler Tibia bei fehlgeschlagenen Osteosynthesen zu geben. Epidemiologie Im Jahr 2017 weist das statistische Bundesamt für die Frakturen des Tibiaschaftes (ICD 10: S82.2) eine Inzidenz von 15/100 000 Einwohner, für die Frakturen der distalen Tibia (ICD 10: S82.3) eine Inzidenz von 15/100 000 und die Frakturen des Innenknöchels (ICD 10: S82.5) eine Inzidenz von 5/100 000 Einwohner aus. Zusätzlich werden multiple Frakturen des Unterschenkels (ICD 10: S82.7) mit 1/100 000 Einwohner, Frakturen sonstiger Teile des Unterschenkels (ICD 10 S82.8) mit 34/100 000 und Frakturen des Unterschenkels-Teil nicht näher bezeichnet (ICD 10: S82.9)mit 1/100 000 Einwohner angegeben [1]. Die Frakturen des Unterschenkels sind somit eine Entität aus der täglichen Versorgungspraxis.

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Value of monoenergetic dual-energy CT (DECT) for artefact reduction from metallic orthopedic implants in post-mortem studies

Abstract: This study demonstrates that monoenergetic DECT images extrapolated at high energy levels significantly reduce metallic artefacts from orthopedic implants and improve image quality compared to SECT examination in forensic imaging.

Cited by 40 publications

References 36 publications

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

Quantifying near metal visibility using dual energy computed tomography and iterative metal artifact reduction in a fracture phantom

Metal Artefact Reduction by Dual-energy Computed Tomography Using Monoenergetic Extrapolation: In-vitro Determination of Optimal Monoenergetic Level with Different Metallic Implants Using a Phantom Body

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen am Tibiaschaft und an der distalen Tibia

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